BEUSCHEL: How will the health care system survive its financial crisis?

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Nov 16, 2017 at 2:00 PM

Thanksgiving is just around the corner, and so I would like to start out by thanking all those people who have chosen a career in the health care field for doing so.

Over the span of my lifetime, doctors have stopped doing house calls and crippling diseases like polio have come under control with vaccines. The services provided by the medical community have expanded with the advances in science and technology. Untreatable, unidentifiable medical conditions have become treatable.

Along with an ever-growing population, medical needs of the populace have grown exponentially. So now we arrive at the “crisis” in the health care. More people, more treatable conditions, more expensive medical equipment, more specialized medical professionals, more care facilities, and on and on it goes. How could this not be a crisis? As advances in medicine are celebrated, the cost of providing them has blindsided the economy.

The first awareness I had of this impending crisis situation was a comment a doctor had made to my husband about 20 years ago. He said, “Insurance/Medicare payments do not even cover the cost of a syringe, much less what is in it.” This doctor was not trying to be a missionary in a third-world country. He was right here in West Michigan. He was a good-hearted soul who immigrated to the USA, lived a modest lifestyle, cared about his patients and was trying to keep his medical practice in the black.

But I could see the reality of what he was saying every time I opened a medical bill that showed what the doctor charged, what the insurance would pay and how much was left to the patient to cover. There was always and still is a gap between the doctor’s charges and what insurance will pay. Does that mean that the doctor is charging too much or the insurance company/Medicare/Medicaid won’t or can’t pay the charges?

If, as the doctor commented that insurance isn’t covering the cost of doing business, than how does the business of health services stay alive?

Given recent input from some friends working at the other end of the medical community as nurses or nurse assistants, I believe that increased margins in some health care facilities comes from understaffing and paying minimum wages. This leads to a high rate of staff turnover and burnout. Health care workers who come in at minimum wage are kept as part time so as not to have to pay them medical insurance. Kind of ironic given the field they work in.

While at Bob Evans recently, our waitress said she had worked as a certified nurse assistant and switched to waitressing to earn more money. How many other health care professionals leave the field because they can’t financially survive?

Another issue for those who choose to stay in the health care field is the expectation for them to work understaffed shifts. This means those who do show up are sometimes doing the jobs of two people. Even if a part-time person wanted to pick up extra shifts to help give adequate shift coverage, they may not be allowed to because they would roll past full-time hours and have to be paid time and a half.

So, rather than adequately cover shifts, the priority seems to be making money. Which is a reminder that hospitals, nursing homes, assisted living facilities and dementia/hospice care facilities are all “for profit”! They are businesses, pure and simple.

Until I really started to hear more and more from health care providers, I naively trusted in the care given to my family members when they have needed medical care. I remember now comments they have made about how long it took for someone to come help them when they buzzed for help. I never thought to ask if their shifts were properly covered with the right number of caregivers. Or to check if the nurse’s instructions for assists by two people were in fact being done by two staff people; i.e., working lift equipment to move patients. Or if the person dispensing meds is dedicated to that job or being expected to fill in the gaps of inadequate shift staffing? Is the health care system finding ways to cut corners at the expense of the quality of care given?

The culture of this country values human life. Through advances in science, medicine and technology, babies born prematurely at under a pound in birth weight can be saved. Organ transplants give many a new lease on life. Joint replacement extends independence. Good nutrition, healthy lifestyles and genetics have extended life expectancy. These are wonderful things, but they come at a price.

The bottom line is that the health care system is a business. Businesses only survive when they are profitable. How this system will survive its financial crisis is beyond me. My sincere hope is that it does.